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Often we are left confused with the many different acne terminologies. Gaining a better understanding of the different types of acne is helpful in order to access the correct type and level of treatments we need. That’s the whole intention of this article.

Don’t feel sad if your acne looks really bad right now, I can assure you that it will get better with proper care. There are many different types of acne conditions, and fortunately, the more severe acne cases are rare and all hope is not lost as medical treatments are available.

The most common type of acne is acne vulgaris. It is America’s most common skin disease which affects an estimated 80% of Americans at some point in their lives. Acne vulgaris is characterized by noninflammatory acne (open and closed comedones) and inflammatory acne (papules, pustules, nodules and cysts). Its severity can range drastically, which may result in permanent physical and mental scarring.

Acne Vulgaris – Noninflammatory acne

Open comedones are a result of the enlargement and dilation of a plug that forms from oil and dead skin cells inside the hair follicle.


A blackhead (open comedo) happens when the hair follicle pore remains open, and exposes a black plug. The dark color is not dirt inside the pore but rather the oil inside the pore which has become exposed to the outside air (oxidized).


A whitehead (closed comedo) forms if the hair follicle pore remaines closed. The plug in the closed comedo or whitehead is not exposed to the outside air, thus it does not develop into a black color. It appears as a tiny, white or pink bump in the skin.


Acne Vulgaris – Inflammatory acne

Inflammatory acne is the more serious type of acne and consists of red blemishes, pimples or zits (also known as papules, pustules), and larger, deeper swollen tender lesions (also known as nodules).


Papules are closed comedones, which have become red, swollen, and inflamed. They have no head and appear as bumps on the skin. Do not squeeze a papule as it can worsen the breakout and is likely to leave a scar.


Pustules are closed comedones, which become inflamed and begin to rupture into the skin forming pustular heads of various sizes. They normally appear as a circular red bump with a white or yellow center. Squeezing a pustule will most likely cause bleeding, and if done incorrectly, can leave an acne mark.


Nodules occur when there is a deep break in the hair follicle and contaminated debris enters the dermis and infects adjoining follicles. It presents itself as a hard, painful lump under the skin. If left untreated, these can produce deep scarring. Unlike other forms of acne, nodules may persist for weeks or even months, and may develop into cysts.


Cysts, while similar to nodules, are softer, pus-filled lesions, also deep under the skin.

Acne Rosacea

Rosacea (pronounced roz-ay-sha) is a chronic skin condition that makes your face turn red and may cause swelling and skin sores that look like acne. Rosacea sufferers often experience flushing and persistent facial redness. Papules and pustules are also common in many rosacea sufferers. As of 2010, rosacea is estimated to affect at least 16 million people in the United States alone and approximately 45 million worldwide.

Severe Forms of Acne

There are other severe forms of acne though they are less common, but as you can see from the photos below, those who suffer from them have to endure challenging hardships and pain.

Acne Conglobata

Acne conglobata is an uncommon, highly inflammatory disease presenting itself with comedones, nodules and numerous large lesions. Although the cause of this type of acne is unknown, it is associated with testosterone and thus appears mainly in men. It is found on the face, chest, back, buttocks, upper arms, and thighs. The most common treatment is the acne medication isotretinoin (Accutane).

Acne Fulminans

Acne fulminans is a severe form of acne, which can occur after the unsuccessful treatment of acne conglobata. Acne fulminans starts as an inflammation in your joints and leads to swelling. It may also cause fever and a loss of appetite. Treatments usually include isotretinoin.

Gram-negative Folliculitis

Gram-negative Folliculitis is an infection caused by gram-negative organisms such as Pseudomonas. It occurs in patients who have had moderately inflammatory acne for long periods and have been treated with long-term antiobiotics, mainly tetracyclines. Treatment involves the use of isotretinoin and systemic antibiotics.

Pyoderma Faciale

Pyoderma faciale, also known as rosacea fulminans, is an uncommon skin condition in young adult women. This condition does not affect males. It can resemble severe acne or rosacea, and present itself as unsightly, painful nodules, pustules and sores which may scar. It starts abruptly and usually does not persist more than a year or so.

Now that you are aware of the different types of acne, take a moment to evaluate which acne condition you’re suffering from. You may want to take a look at this acne skin care which has proven to be effective against my acne vulgaris. For more severe acne cases, I would advise that you get treatment immediately from your trusted dermatologist.